Link: Scientific Misconduct: A Form of White Coat Crime
Kline, Sandy
Wednesday, April 16, 2014
Sunday, April 13, 2014
Kaiser Permanente pharmacists consider going on strike
See also Kaiser often denies care to paying patients, but then doles out a bit of free care to get publicity and tax write-offs.
Kaiser Permanente pharmacists consider going on strike
By ALEJANDRO CANO
Fontana Herald News
April 13, 2014
Kaiser Permanente pharmacists, including those in the Fontana medical center, voted on April 4 to authorize the Guild for Professional Pharmacists committee to call a strike, if necessary, after negotiations reached no agreement.
According to the GFPP, which represents more than 1,400 pharmacists in Southern California, the employees "overwhelmingly" authorized the committee to call a strike after Kaiser’s bargaining team did not offer better health coverage plans and retirement plans for employees who work for less than full time.
“Kaiser has, so far, steadfastly refused to do so and, instead, has sought benefits cuts that would give pharmacists even lesser benefits both wile actively employed by Kaiser and after retirement," said Robin Borden, president of GFPP. “This is outrageous and our members won’t stand for it. While I know no one wants to strike -- least all of our members, for whom patients come first -- our members will not stand by and let Kaiser undermine our economic security, including our security after retirement."
Borden added that if the strike were to be called, it could involve all or some of the following Kaiser medical centers: Panorama City, Woodland Hills, Sunset, West Los Angeles, Baldwin Park, Bellflower, Harbor South Bay, Anaheim, Irvine, Ontario, Riverside, San Diego and Fontana.
Kaiser Permanente released a statement through Jennifer Resch-Silvestri, senior director of public affairs and brand communications in the San Bernardino County area, saying that the company's first priority is “always the safety and care of our members and patients” and that pharmacists are “valued members of our professional health care team."
“It is important to note that all Kaiser Permanente health services are open and operating as usual to serve our members who should continue to come to our facilities for their appointments, lab tests, scheduled procedures, and to see their doctors," said the statement. “With the good faith involvement of all concerned, we are optimistic that we will continue to make
progress toward a contract agreement."
Kaiser Permanente pharmacists consider going on strike
By ALEJANDRO CANO
Fontana Herald News
April 13, 2014
Kaiser Permanente pharmacists, including those in the Fontana medical center, voted on April 4 to authorize the Guild for Professional Pharmacists committee to call a strike, if necessary, after negotiations reached no agreement.
According to the GFPP, which represents more than 1,400 pharmacists in Southern California, the employees "overwhelmingly" authorized the committee to call a strike after Kaiser’s bargaining team did not offer better health coverage plans and retirement plans for employees who work for less than full time.
“Kaiser has, so far, steadfastly refused to do so and, instead, has sought benefits cuts that would give pharmacists even lesser benefits both wile actively employed by Kaiser and after retirement," said Robin Borden, president of GFPP. “This is outrageous and our members won’t stand for it. While I know no one wants to strike -- least all of our members, for whom patients come first -- our members will not stand by and let Kaiser undermine our economic security, including our security after retirement."
Borden added that if the strike were to be called, it could involve all or some of the following Kaiser medical centers: Panorama City, Woodland Hills, Sunset, West Los Angeles, Baldwin Park, Bellflower, Harbor South Bay, Anaheim, Irvine, Ontario, Riverside, San Diego and Fontana.
Kaiser Permanente released a statement through Jennifer Resch-Silvestri, senior director of public affairs and brand communications in the San Bernardino County area, saying that the company's first priority is “always the safety and care of our members and patients” and that pharmacists are “valued members of our professional health care team."
“It is important to note that all Kaiser Permanente health services are open and operating as usual to serve our members who should continue to come to our facilities for their appointments, lab tests, scheduled procedures, and to see their doctors," said the statement. “With the good faith involvement of all concerned, we are optimistic that we will continue to make
progress toward a contract agreement."
Kaiser often denies care to paying patients, but then doles out a bit of free care to get publicity
See what Kaiser does to paying patients at Garfield Specialty Center.
The fourth paragraph of the following article is shockingly deceptive, not giving even a clue that 20 non-Kaiser Permanente hospitals are involved in Project Access.
30 Get Free Treatment on ‘Super Saturday Surgery Day’ at Kaiser
by Chris Jennewein (former San Diego Union-Tribune administrator)
Times of San Diego
April 12, 2014
Nearly 30 San Diegans with debilitating medical conditions are scheduled to receive free treatment Saturday at a “Super Saturday Surgery Day” conducted by the San Diego County Medical Society Foundation and Kaiser Permanente.
About 150 physicians and staff will volunteer time and expertise to provide medical care to the patients. Kaiser Permanente Garfield Specialty Center in San Diego.
For 13 of them, treatments will include hernia repairs, gallbladder removals, head and neck therapy, and vascular surgery. Another 16 patients will receive diagnostic gastrointestinal procedures to prevent colorectal cancer.
Barbara Mandel, Executive Director of the San Diego County Medical Society Foundation, said that since the Project Access San Diego program started in December of 2008, more than 2,400 patients have received free specialty care, including both inpatient and outpatient surgeries and procedures.
Kaiser says it has held a dozen Super Saturdays, providing more than $2.4 million in services.
To qualify for Project Access San Diego’s Saturday Surgery Day an individual must live in San Diego County, be low-income, ineligible for public health programs, and be referred by their primary care physician.
— City News Service
The fourth paragraph of the following article is shockingly deceptive, not giving even a clue that 20 non-Kaiser Permanente hospitals are involved in Project Access.
30 Get Free Treatment on ‘Super Saturday Surgery Day’ at Kaiser
by Chris Jennewein (former San Diego Union-Tribune administrator)
Times of San Diego
April 12, 2014
Nearly 30 San Diegans with debilitating medical conditions are scheduled to receive free treatment Saturday at a “Super Saturday Surgery Day” conducted by the San Diego County Medical Society Foundation and Kaiser Permanente.
About 150 physicians and staff will volunteer time and expertise to provide medical care to the patients. Kaiser Permanente Garfield Specialty Center in San Diego.
For 13 of them, treatments will include hernia repairs, gallbladder removals, head and neck therapy, and vascular surgery. Another 16 patients will receive diagnostic gastrointestinal procedures to prevent colorectal cancer.
Barbara Mandel, Executive Director of the San Diego County Medical Society Foundation, said that since the Project Access San Diego program started in December of 2008, more than 2,400 patients have received free specialty care, including both inpatient and outpatient surgeries and procedures.
[Maura Larkins' comment: Journalist Chris Jennewein fails to mention that all this care DID NOT COME FROM KAISER PERMANENTE. Only some of it came from Kaiser. Here's a list of hospitals involved in the program:
Alvarado Hospital
Carlsbad Surgery Center
Coast Surgery Center
The Endoscopy Center
Endoscopy Center of Chula Vista
Escondido Surgery Center
Euclid Endoscopy Center
Kaiser Permanente
La Jolla Endoscopy Center
Northcoast Surgery Center
Orthopaedic Surgery Center of La Jolla
Otay Lakes Surgery Center
Palomar Pomerado Health
Paradise Valley Hospital
Parkway Endoscopy Center
Poway Surgery Center
San Diego Outpatient Ambulatory Surgical Center
Scripps Health
Surgical Center of San Diego
Tri-City Medical Center
University of California San Diego Medical Center]
Kaiser says it has held a dozen Super Saturdays, providing more than $2.4 million in services.
[Maura Larkins' comment: Who came up with that number? Perhaps Kaiser values its own services very highly? I expect Southern California Permanente Medical Group will use this as a tax write-off, so it would be expedient to exaggerate the value of the service.]
To qualify for Project Access San Diego’s Saturday Surgery Day an individual must live in San Diego County, be low-income, ineligible for public health programs, and be referred by their primary care physician.
— City News Service
Wednesday, April 9, 2014
This 32-Year-Old Florida Woman Is Dead Because Her State Refused To Expand Medicai
Charlene Dill died because Florida Republicans refused to expand Medicaid that would have paid for her heart health care CREDIT: GoFundMe
This 32-Year-Old Florida Woman Is Dead Because Her State Refused To Expand Medicaid
By Tara Culp-Ressler
Think Progress
April 9, 2014
Charlene Dill, a 32-year-old mother of three, collapsed and died on a stranger’s floor at the end of March. She was at an appointment to try to sell a vacuum cleaner, one of the three part-time jobs that she worked to try to make ends meet for her family. Her death was a result of a documented heart condition — and it could have been prevented.
Dill was uninsured, and she went years without the care she needed to address her chronic conditions because she couldn’t afford it.
Under the health reform law, which seeks to expand coverage to millions of low-income Americans, Dill wasn’t supposed to lack insurance. She was supposed to have access to a public health plan through the law’s expansion of the Medicaid program. But Dill, a Florida resident, is one of the millions of Americans living in a state that has refused to accept Obamacare’s Medicaid expansion after the Supreme Court ruled this provision to be optional. Those low-income people have been left in a coverage gap, making too much income to qualify for a public Medicaid plan but too little income to qualify for the federal subsidies to buy a plan on Obamacare’s private exchanges.
Florida has one of the highest uninsurance rates in the nation, and is home to a disproportionately large number of residents who struggle to afford health services. Nonetheless, lawmakers have continued to resist accepting generous federal funds to expand Medicaid to an estimated 750,000 low-income Floridians like Dill.
Although Florida Gov. Rick Scott (R) initially indicated that he was in favor of accepting the funds for expansion, he’s since walked back that position. Meanwhile, Republicans in the legislature don’t even plan to schedule a vote to address Medicaid expansion during their current session, suggesting that the federal government won’t actually come through with the funding to support the policy.
Dill made about $9,000 annually by babysitting, cleaning houses, and selling vacuum cleaners. As the Orlando Weekly reports, she was optimistic about her coverage options under President Obama’s administration. She tried to sign up for Obamacare using the online calculator on HealthCare.gov, but quickly found out she fell within the coverage gap.
In the absence of health coverage, Dill’s best friend, Kathleen Voss Woolrich, occasionally turned to crowdfunding sites on the internet to raise the money Dill needed to pay for her heart medication. Last month, Woolrich crowdfunded to pay for Dill’s funeral.
In an emotional blog post published on the site Women on the Move at the end of last month, Woolrich blamed Florida politicians for her friend’s early death.
“You see the main argument Republicans use is that it’s some lazy person who needs Medicaid expansion. That those of us living without healthcare or dental care are lazy. But my friend, a single beautiful mother, worked three jobs,” Woolrich wrote. “I am burying my best friend because of the policies of the Republican Party. I am burying my best friend because had Medicaid expanded, her needs would have been met.”
And Dill won’t be the only one. A recent study conducted by Harvard researchers estimated that as many as 17,000 people will die directly as a result of their states refusing to expand Medicaid. In Florida, that translates to about six deaths like Dill’s every single day. This issue is exacerbated by the fact that the low-income residents in states that have resisted Medicaid expansion tend to have more health problems than the residents in other states.
Democratic officials in Florida have responded strongly to Woolrich’s story. Rep. Alan Grayson (D) — who told the Orlando Weekly that his colleaugues’ resistance to Medicaid expansion “has put the GOP’s appalling disregard for human life on full display” — entered Woolrich’s blog post into the Congressional record.
“I memorialized Charlene’s life and death in the Congressional Record, because the Republicans want to pretend that none of this is happening. That Charlene didn’t die as a result of their callous neglect — that no Floridians will die as a result of their willful refusal to expand Medicaid at no cost,” Grayson explained. “But I’m not going to let them forget. I’m not going to let them pretend. This is not a game; this is very real. This is life and death.”
Tuesday, April 8, 2014
Did a dead woman beat herself up--or did her doctor wrongly pronounce her as dead?
Arroyo v. Plosay (Cal. Ct. App. - April 2, 2014)
California Appellate Report
Thoughts on recent Ninth Circuit and California appellate cases from Professor Shaun Martin at the University of San Diego School of Law.
April 02, 2014
Maria Arroyo dies, and when the mortuary comes to pick up her body, her face is all bashed in, which the mortuary can't fix. Since Arroyo simply died of a heart attack -- not something that usually bashes a face -- everyone assumes that someone in the hospital must have futzed with (or mutilated) the body. So in 2011, Arroyo's survivors sue the hospital for disfiguring the body, which is indeed a tort.
But plaintiffs end up dismissing the case without prejudice after the trial court grants various summary judgment motions. Oh well. That's the way the cookie crumbles sometimes.
But then Arroyo's survivors figure out what really went down. How did Maria's face get bashed in? Well, after she was pronounced dead by the medical staff at the hospital, she was taken to the morgue and put in a compartment in the hospital's freezer. Presumably one of those drawer-like things that you see on television.
But when the mortuary workers found her, Arroyo was face down. With her nose broken and with lacerations and contusions all over her face.
How'd she get that way? You guessed it. The survivors' expert says that Maria was still alive when the hospital declared her dead and put her in the freezer. And that, later, she woke up, bashed her face and head against the compartment in a vain attempt to escape, and ultimately just froze to death.
YIKES!!
There's a whole big statute of limitations problem. Which, as the Court of Appeal holds, is more fatal to one cause of action than some of the others.
But boy. I would not want to be defending this one. Because unless you've got a good way to explain to a jury how Maria ended up face down with her nose broken, the alternative -- that she was put in the morgue alive only to freeze to death -- is . . . well, chilling. To say the least...
The decision states, "The separate judgments
of dismissal are reversed as to the causes of
action for medical negligence and wrongful
death against the Hospital and Dr. Plosay
, and affirmed as to the cause of action for
negligence.
The parties shall
bear their own costs on appeal.
California Appellate Report
Thoughts on recent Ninth Circuit and California appellate cases from Professor Shaun Martin at the University of San Diego School of Law.
April 02, 2014
Maria Arroyo dies, and when the mortuary comes to pick up her body, her face is all bashed in, which the mortuary can't fix. Since Arroyo simply died of a heart attack -- not something that usually bashes a face -- everyone assumes that someone in the hospital must have futzed with (or mutilated) the body. So in 2011, Arroyo's survivors sue the hospital for disfiguring the body, which is indeed a tort.
But plaintiffs end up dismissing the case without prejudice after the trial court grants various summary judgment motions. Oh well. That's the way the cookie crumbles sometimes.
But then Arroyo's survivors figure out what really went down. How did Maria's face get bashed in? Well, after she was pronounced dead by the medical staff at the hospital, she was taken to the morgue and put in a compartment in the hospital's freezer. Presumably one of those drawer-like things that you see on television.
But when the mortuary workers found her, Arroyo was face down. With her nose broken and with lacerations and contusions all over her face.
How'd she get that way? You guessed it. The survivors' expert says that Maria was still alive when the hospital declared her dead and put her in the freezer. And that, later, she woke up, bashed her face and head against the compartment in a vain attempt to escape, and ultimately just froze to death.
YIKES!!
There's a whole big statute of limitations problem. Which, as the Court of Appeal holds, is more fatal to one cause of action than some of the others.
But boy. I would not want to be defending this one. Because unless you've got a good way to explain to a jury how Maria ended up face down with her nose broken, the alternative -- that she was put in the morgue alive only to freeze to death -- is . . . well, chilling. To say the least...
The decision states, "The separate judgments
of dismissal are reversed as to the causes of
action for medical negligence and wrongful
death against the Hospital and Dr. Plosay
, and affirmed as to the cause of action for
negligence.
The parties shall
bear their own costs on appeal.
Monday, April 7, 2014
I No Longer Have Much Faith in the Staff At This Hospital
by irishwitch
Daily Kos
Jan 28, 2014
...SInce I was up that early, I called Faye and told her I needed to get to the hospital today. I didn't tell her I had a really, really bad feeling about it. When we got there, Ben was upbeat (they put him on Zoloft and I want him off as soon as possible because the side effects are dreadful) because he thought he'd be going home today.
Our hopes were dashed. Very badly dashed and I am frankly thinking LAWSUIT because some of the stuff I am finally hearing indicates a level of incompetence that to me is just unbelievable. He is still on oxygen. His oxygen saturation isn't good enough to go home. Her boss and the cardiologist were fine discharging him, but the O2 levels when he walks go way down. So she decided he might have a blood clot in his luings, which apparently the oh-so-brilliant top 5 cardio hospitals in the country completely missed comp;etely.
I am the edn of my rope. I got very aggressive with the PA. I asked her why, when I asked the nurse about Deep Vein Thrombosis, said it was DVT, just a small superficial clot, othing to worry about. Nicole the PA said all clots are DVT, w=hich the AMerican Heart Association website (and several others that were not designed for civilians but for medical people) say is not true.
So they did a CAT scan, and NOW he had DVT behind his knee and a clot in his lung.
WHY THE FRIGGIN' HELL did they not do that CAT Scan when they discovered the one in his knee AND they knew he was having real problems breathing (turns out it was pneumonia which nobody bothered to tell us)? This sounds to me like GROSS incompetence. If there is a step beyond gross incompetence.
I was very aggressive in my questioning of Nicole, and MiL was mortified by aggressiveness and stopped out, leaving me unsure if she was leaving me there. I embarrassed her because I wanted to know the damned truth and was willing to have a knock-down dragout fight to get the facts. Because what I have gotten so far is at best half truths. And I am not passive aggressive. I WILL go to them at to learn the complete whole truth (which goes over with Nicole like a lead balloon and makes Ben unhappy with me). But so far they have made what seemed to me to have made so many mistakes which could have cost him his life, that I honestly have lost all faith in ANYONE at that hospital.ANd I wish I were ip North where family is respected and they actually the time to tell you the truth and generally don't make errors like not checking for a second clot in the lungs when his breathing isn't improving.
I'd also be thrilled to have nurses who speak something resembling the English language. His nurse today had a Southern accent so thick as to be unintelligible--and I can understand broad Yorkshire, thick Glaswegian, and very heavy Northern Irish brogues (reviews on Netflix always whine that they can't understand Irish accents)
I finally called Ben to get the info (since calling the damned nurses seems to be utterly useless), and heard about the blood clot. I have been crying non-stop and I no longer have any faith in this hospital or its staff. They've either been too incompetent to answer or they give me half truths. I don't trust any of them...
Wal-Mart shoppers: Kaiser Permanente will see you now
Wal-Mart shoppers: The doctor will see you now
BY COURTENAY EDELHART
Bakersfield Californian
Apr 05 2014
Shortly after the Kaiser Permanente Care Corner clinic opened for the day in a southwest Bakersfield Wal-Mart one recent Friday, licensed vocational nurse Irene Ethridge decided to drum up some business.
[Maura Larkins' comment: Irene decided? Or she was instructed to do so?}
"Hi there. Are you a Kaiser Permanente member?" she asked a woman strolling through the store's adjacent pharmacy.
"Yes," replied Kim Klaas warily.
Ethridge brightened and explained that as such, Klaas was eligible to use the telemedicine services at the clinic, a two-year pilot project of Kaiser -- which has about 102,000 members in Kern County -- and the nation's largest retailer.
The Bakersfield telemedicine clinic is one of two that Kaiser opened in October. The other one is in Palmdale.
Kaiser members and Wal-Mart employees can walk in, no appointment necessary, and have minor ailments assessed by a health care provider via a high-resolution webcam in a private room. A registered nurse in San Diego does an initial screening, followed by an urgent care doctor in Bakersfield.
The clinic is open from noon to 8 p.m. Thursdays through Mondays. About 125 people have had exams there so far.
Klaas, 39, was feeling well on Friday, but she was intrigued. "I love the hours," said the mother of two children, ages 5 and 6. "Kids always seem to get sick at night when the doctor's office is closed, and a little ear ache isn't the kind of thing you want to go to a hospital for." Retailers have been operating clinics inside stores for years, but until recently telemedicine has largely been confined to traditional clinical settings, usually for consultations between far apart medical colleagues. Because it's efficient and convenient, telemedicine is likely to expand into all sorts of nontraditional settings, but there should be standards to ensure patients are getting good care, said Mike Harris, a principal with Harris Consulting, a Los Angeles-based healthcare consulting firm. "Of course we have to make sure we closely monitor it to be certain we're not putting patients at risk," he said. The exam at Kaiser's Wal-Mart clinic is much more than just talking to a computer screen, Kaiser notes. With a specialized stethoscope placed on the patient by the nurse at the clinic, remote doctors can actually listen to the patient's breathing and heartbeat, just as they would in a face-to-face exam. An otoscope with a camera on it also allows doctors to look deep into a patient's ears and eyes. Similarly, a special dermatoscope can transmit extremely detailed, magnified images of skin lesions. Patients with sore throats open wide for yet another camera. For routine ailments, doctors can transmit an electronic prescription that patients can fill immediately at Wal-Mart, or at another pharmacy if they choose to wait. If the condition appears to warrant an in-person exam, patients are referred to Kaiser's urgent care clinic on Stockdale Highway, where they will likely see the same doctor who was on the other end of the webcam. The partnership between Kaiser and Wal-Mart is part of an ongoing strategy Kaiser is pursuing to make health care generally more accessible. It's trying out a traditional clinic at Paramount Farms for employees of the agriculture company, and a mobile clinic that travels to outlying areas of the county six days a week. There's also a mobile phone app for making appointments and communicating with doctors. "We want to take health care beyond the traditional setting to the places where people shop and work," said Kaiser chief administrative officer Sharon Peters. If visiting the doctor is convenient, the thinking goes, patients will come in sooner and possibly avoid the health consequences and expense of more severe problems down the road.
Going to a doctor's office in the middle of the day isn't convenient for most people, but swinging through a clinic while shopping isn't too much trouble.
"This really fits in with the needs of our patients," said Kaiser medical director Dr. Julia Bae. "Millennials and the younger population, especially, don't value the traditional one-on-one office visit. They want care to fit into their busy schedules." Wal-Mart says the experiment is one more way to better serve its customers.
"We are always testing new products and services to provide our customers with affordable ways to stay healthy," said spokeswoman Danit Marquardt. "This is an example of one of those pilot programs." Customers who are not Kaiser members or Wal-Mart employees can't take advantage of the telemedicine exams, but they can use self-service options such as health research or checking their weight or blood pressure. Linda Urias, 65, doesn't belong to Kaiser but stops in at the clinic whenever she's in the store picking up groceries. On the recent Friday, she checked her blood pressure. "A little low today, but at least it wasn't high," she said. Urias also stepped on a scale to make sure her diet is still on track. She recently lost about 20 pounds, and is trying to keep it off. "I've changed the whole way I eat," Urias said proudly. It's those types of health conscious consumers retailers hope to appeal to with in-store clinics.
The partnership between Kaiser and Wal-Mart has a lot to offer both sides, said healthcare consultant MaryKate Scott of Hartland, Maine-based Scott & Co., which has had Wal-Mart as a client in the past.
The obvious benefit to Wal-Mart is the potential to sell prescription and over-the-counter medicine, but that's only part of the story, Scott said.
There are about 2,500 retail clinics in the United States. Stores like them because they generate foot traffic at a time when a growing number of consumers are shopping online.
"They want customers walking through the store with their shopping carts making impulse purchases," Scott said. Plus, health care costs are a major concern for Wal-Mart as the employer of some 1.4 million employees. If it can keep those workers healthy, that's a huge savings, Scott said. And if health care costs worry an enormously successful international retailer, how much more so for its customers, typically working-class people for whom insurance is a major expense. "If I'm Wal-Mart, I'm thinking, 'Health care is a big deal for my customers. And if it's a big deal for my customers, it better be a big deal for me,'" Scott said.
BY COURTENAY EDELHART
Bakersfield Californian
Apr 05 2014
Shortly after the Kaiser Permanente Care Corner clinic opened for the day in a southwest Bakersfield Wal-Mart one recent Friday, licensed vocational nurse Irene Ethridge decided to drum up some business.
[Maura Larkins' comment: Irene decided? Or she was instructed to do so?}
"Hi there. Are you a Kaiser Permanente member?" she asked a woman strolling through the store's adjacent pharmacy.
"Yes," replied Kim Klaas warily.
Ethridge brightened and explained that as such, Klaas was eligible to use the telemedicine services at the clinic, a two-year pilot project of Kaiser -- which has about 102,000 members in Kern County -- and the nation's largest retailer.
The Bakersfield telemedicine clinic is one of two that Kaiser opened in October. The other one is in Palmdale.
Kaiser members and Wal-Mart employees can walk in, no appointment necessary, and have minor ailments assessed by a health care provider via a high-resolution webcam in a private room. A registered nurse in San Diego does an initial screening, followed by an urgent care doctor in Bakersfield.
The clinic is open from noon to 8 p.m. Thursdays through Mondays. About 125 people have had exams there so far.
Klaas, 39, was feeling well on Friday, but she was intrigued. "I love the hours," said the mother of two children, ages 5 and 6. "Kids always seem to get sick at night when the doctor's office is closed, and a little ear ache isn't the kind of thing you want to go to a hospital for." Retailers have been operating clinics inside stores for years, but until recently telemedicine has largely been confined to traditional clinical settings, usually for consultations between far apart medical colleagues. Because it's efficient and convenient, telemedicine is likely to expand into all sorts of nontraditional settings, but there should be standards to ensure patients are getting good care, said Mike Harris, a principal with Harris Consulting, a Los Angeles-based healthcare consulting firm. "Of course we have to make sure we closely monitor it to be certain we're not putting patients at risk," he said. The exam at Kaiser's Wal-Mart clinic is much more than just talking to a computer screen, Kaiser notes. With a specialized stethoscope placed on the patient by the nurse at the clinic, remote doctors can actually listen to the patient's breathing and heartbeat, just as they would in a face-to-face exam. An otoscope with a camera on it also allows doctors to look deep into a patient's ears and eyes. Similarly, a special dermatoscope can transmit extremely detailed, magnified images of skin lesions. Patients with sore throats open wide for yet another camera. For routine ailments, doctors can transmit an electronic prescription that patients can fill immediately at Wal-Mart, or at another pharmacy if they choose to wait. If the condition appears to warrant an in-person exam, patients are referred to Kaiser's urgent care clinic on Stockdale Highway, where they will likely see the same doctor who was on the other end of the webcam. The partnership between Kaiser and Wal-Mart is part of an ongoing strategy Kaiser is pursuing to make health care generally more accessible. It's trying out a traditional clinic at Paramount Farms for employees of the agriculture company, and a mobile clinic that travels to outlying areas of the county six days a week. There's also a mobile phone app for making appointments and communicating with doctors. "We want to take health care beyond the traditional setting to the places where people shop and work," said Kaiser chief administrative officer Sharon Peters. If visiting the doctor is convenient, the thinking goes, patients will come in sooner and possibly avoid the health consequences and expense of more severe problems down the road.
Going to a doctor's office in the middle of the day isn't convenient for most people, but swinging through a clinic while shopping isn't too much trouble.
"This really fits in with the needs of our patients," said Kaiser medical director Dr. Julia Bae. "Millennials and the younger population, especially, don't value the traditional one-on-one office visit. They want care to fit into their busy schedules." Wal-Mart says the experiment is one more way to better serve its customers.
"We are always testing new products and services to provide our customers with affordable ways to stay healthy," said spokeswoman Danit Marquardt. "This is an example of one of those pilot programs." Customers who are not Kaiser members or Wal-Mart employees can't take advantage of the telemedicine exams, but they can use self-service options such as health research or checking their weight or blood pressure. Linda Urias, 65, doesn't belong to Kaiser but stops in at the clinic whenever she's in the store picking up groceries. On the recent Friday, she checked her blood pressure. "A little low today, but at least it wasn't high," she said. Urias also stepped on a scale to make sure her diet is still on track. She recently lost about 20 pounds, and is trying to keep it off. "I've changed the whole way I eat," Urias said proudly. It's those types of health conscious consumers retailers hope to appeal to with in-store clinics.
The partnership between Kaiser and Wal-Mart has a lot to offer both sides, said healthcare consultant MaryKate Scott of Hartland, Maine-based Scott & Co., which has had Wal-Mart as a client in the past.
The obvious benefit to Wal-Mart is the potential to sell prescription and over-the-counter medicine, but that's only part of the story, Scott said.
There are about 2,500 retail clinics in the United States. Stores like them because they generate foot traffic at a time when a growing number of consumers are shopping online.
"They want customers walking through the store with their shopping carts making impulse purchases," Scott said. Plus, health care costs are a major concern for Wal-Mart as the employer of some 1.4 million employees. If it can keep those workers healthy, that's a huge savings, Scott said. And if health care costs worry an enormously successful international retailer, how much more so for its customers, typically working-class people for whom insurance is a major expense. "If I'm Wal-Mart, I'm thinking, 'Health care is a big deal for my customers. And if it's a big deal for my customers, it better be a big deal for me,'" Scott said.
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